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ARUL DORAISWAMY, MD, APC
The Pain Clinic of Hemet
____________________________________________________________________________ _
1264 East Latham Ave, Hemet CA 92543 Phone (951) 925-3600 Fax (888) 491-6419
RISKS, BENEFITS, AND ALTERNATIVES TO OPIOID/NARCOTIC THERAPY
Opioid medications (also called opiates or narcotics) are potent painkillers. The potential BENEFIT of opioid
medications is the reduction in your pain, so you can function better at work, school, home, and in relationships.
Opioids are generally not the first thing you should try to treat your pain. Depending on your pain condition, some
ALTERNATIVES to opioid pain medications can include: exercise/weight loss, activity modification, physical therapy,
non-opioid pain medications, psychological counseling, relaxation techniques/biofeedback, support groups,
acupuncture & other alternative therapies, and medical procedures such as injections or surgery.
RISKS and side effects of opioid/narcotic pain medications include:
– Decreased breathing, which can lead to overdose and death.
– Sleepiness, tiredness, and/or dizziness, which can cause you to fall or pass-out, potentially causing serious injury.
– Slower reactions (physical and mental) that can reduce alertness or judgment.
– Depression, feeling “low” or “high”, and seeing or hearing things that aren’t there.
– Constipation (the most common side effect) and difficulty urinating.
– Itching, sweating, nausea, vomiting, shaking, twitching, and/or dry mouth.
– Low levels of testosterone (a hormone) in men, which can cause lower sex drive, energy, strength, and bone mass.
– Altered taste, vision, heart rate, and/or blood pressure.
– Developing opioid tolerance (the opioid analgesic gets less effective with time, which can make acute pain after an
injury or surgery more difficult to treat), and/or becoming more sensitive to pain (opioid-induced hyperalgesia).
– Physical dependence, which will result in withdrawal symptoms if the opioid medication is suddenly stopped.
– Psychological addiction.
– Risks in pregnancy, including but not limited to the potential for growth retardation of your baby in the womb, your
baby being born in narcotic withdrawal, and preterm labor if you go through opioid withdrawal during pregnancy.
You need to follow some IMPORTANT GUIDELINES when taking prescribed opioid/narcotic pain medications:
1. Frequently talk with your pain management provider about your pain medications. Ask questions. Be sure you
understand what you’re taking, why you’re taking it, and how to take it. At the pharmacy, make sure you understand
the directions. Read the directions on the bottle and see if they make sense to you. If they don’t, ask the pharmacist
to explain. Make sure you inform your doctor if you are developing any opioid side-effects, or if you feel you are
getting psychologically addicted to your pain medications.
2. Tell each of your doctors that you are taking opioid pain medications, and keep them updated on all the
medications you are taking (even over-the-counter meds). If you do not update your doctors about your current
medications, you may be prescribed incompatible medications that can increase your risk for fatal drug interactions.
3. Tell your doctor if you have any signs associated with sleep apnea (pauses in breathing during sleep, snoring, or
tiredness during the day), which may put you at increased risk for respiratory arrest when taking opioids. Tell those
you are living with that you are on a medication that can affect your breathing. Ask them to watch for decreased
breathing or the inability to wake up. If breathing problems happen, they should call 911 immediately.
4. Do NOT ever take more pain medication than your doctor prescribed, due to risk for overdose. Even on days
when your pain is particularly severe, NEVER take a higher dose without first clearing it with your pain management
provider. In fact, if you feel sleepy, you should skip your pain medication doses.
5. Do NOT take sleep aids, anti-anxiety medications, or other pain relievers (not even Tylenol) while taking
prescription pain medication, without your pain doctor’s permission. NEVER drink alcohol or take illicit, illegal, or
recreational drugs while taking pain medications.
6. Do NOT share your narcotic medications with anyone, even family members who are in pain. Sharing pain
medication is ILLEGAL. Keep your narcotics in a locked cabinet or safe. Keep them out of reach of children and
others in your home. Keep track of how many pills you have, so you don't run out and go into opioid withdrawal.
7. Do NOT drive a motor vehicle or operate dangerous machinery under the influence of opioid or other potentially
sedating medications. Opioids can slow your reflexes and affect your judgment. If you drive unsafely, opioids can be
a reason for you to receive a DUI charge (driving under the influence).
If you have any questions about the above information, please discuss them with your pain management
provider prior to filling your opioid pain medication prescription.
NEXT APPOINTMENT: